Organization
NEUROLOGY, MOVEMENT DISORDERS AND DYSTONIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANJAY P. RATHI M.D. (SOLE MEMBER)
(203) 773-3245
Entity
Organization
Contact information
Practice address
14 PECK ST, NORTH HAVEN, CT 06473-2307
(203) 773-3245
(203) 777-3588
Mailing address
14 PECK ST, NORTH HAVEN, CT 06473-2307
(203) 773-3245
(203) 777-3588
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
037827
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130000557
MEDICARE PTAN
CT
Enumeration date
11/20/2014
Last updated
10/06/2015
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